Citation Nr: 21026612 Decision Date: 05/03/21 Archive Date: 05/03/21 DOCKET NO. 14-17 665 DATE: May 3, 2021 REMANDED Service connection for hepatitis C is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from September 1966 to July 1968, including foreign service in the Republic of Vietnam. For his meritorious service, the Veteran was awarded (among other decorations) the Vietnam Campaign Medal and Vietnam Service Medal. Historically, the Board of Veterans' Appeals (Board) denied this appeal in September 2019. However, the Court of Appeals for Veterans Claims (Court) vacated this determination and remanded the matter for further consideration in June 2020. The matter has since been returned to the Board for further review. Of note, the Board also remanded service connection claims for tinnitus, ear, and psychiatric disabilities in September 2019. Development for these matters is ongoing, such that they will be addressed in a separate Board decision. Turning to the instant matter, the June 2020 Joint Motion for Partial Remand (JMPR) submitted to the Court notes that the Veteran was not afforded a VA examination with respect to his claim. Upon contemporaneous review of the claims file, the Board finds competent evidence of a current disorder with a possible nexus to service. See McLendon v. Nicholson, 20 Vet. App. 79, 83 (2006); see generally VA treatment records (documenting a history of chronic hepatitis C); May 2014 VA Form 9 (contending that the Veteran's condition was caused by in-service injector guns). Accordingly, a remand is required such that a nexus opinion may be obtained. Also as noted by the parties in their JMPR, the Board cited to two VA Fast Letters in its prior denial. However, these letters are not currently associated with the record. On remand, new copies of this evidence should be obtained. The matter is REMANDED for the following actions: 1. Obtain and associate with the record the following documents, which address known risk factors for hepatitis C: (a.) VBS Fast Letter 211B (98-110) (November 30, 1998); (b.) VBS Fast Letter 04-13 (June 29, 2004). 2. Thereafter, obtain an opinion addressing the questions below. If the reviewing examiner determines that the opinions requested may not be offered without first examining the Veteran, then consider whether a telehealth interview may be appropriate. Schedule an in-person examination only if deemed necessary to answer the questions below. The claims file and a copy of this remand must be made available for review, and the examination reports must reflect that review of the claims file occurred. In particular, the examiner should offer opinions as to the following: (a.) Indicate whether the Veteran has demonstrated hepatitis C (or any residuals of that disease) during the period on appeal. (b.) If so, opine as to whether it is at least as likely as not (50 percent probability or more) that the condition began in service, was caused by service, or is otherwise related to service, including in-service inoculations with an injector gun. The examiner must explicitly address the Veteran's testimony on this matter, and the two VBS Fast Letters cited above. In formulating the opinions, the examiner is advised that the term "at least as likely as not" does not mean "within the realm of possibility." Rather, it means that the weight of the medical evidence for and against the claim is so evenly divided that it is as medically sound to find in favor of the claim as it is to find against it. [CONTINUED ON NEXT PAGE] A complete rationale must be provided for all opinions or conclusions expressed. It should be noted that the Veteran was competent to attest to observable symptomatology. If there is a medical basis to support or doubt the history provided by the Veteran, the examiner should provide a fully reasoned explanation. Evan M. Deichert Veterans Law Judge Board of Veterans' Appeals Attorney for the Board K. Kovarovic, Counsel The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.